NCT05889416

Brief Summary

The goal of this open-label cluster-randomized effectiveness-implementation hybrid trial is to study whether a) audit and feedback of cardiac rehabilitation service delivery within a national quality registry and b) structured implementation support can improve center-level adherence to guidelines and short and long-term patient-level outcomes.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
75

participants targeted

Target at P50-P75 for not_applicable

Timeline
55mo left

Started Oct 2023

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
enrolling by invitation

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress36%
Oct 2023Dec 2030

First Submitted

Initial submission to the registry

March 23, 2023

Completed
2 months until next milestone

First Posted

Study publicly available on registry

June 5, 2023

Completed
4 months until next milestone

Study Start

First participant enrolled

October 1, 2023

Completed
3.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2026

Expected
4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2030

Last Updated

November 29, 2024

Status Verified

November 1, 2024

Enrollment Period

3.2 years

First QC Date

March 23, 2023

Last Update Submit

November 27, 2024

Conditions

Keywords

Myocardial infarctionCardiac rehabilitationSecondary preventionAuditImplementationPractice facilitation

Outcome Measures

Primary Outcomes (1)

  • Adherence score

    The adherence score reflects center-level adherence to CR processes and structures as recommended in national guidelines on secondary prevention. The score is derived from 39 variables capturing guideline-directed CR structure and processes collected on center-level through the national cardiac registry SWEDEHEART. The score ranges from 0 (worst) to 39 (best).

    3 years

Secondary Outcomes (15)

  • Blood pressure target attainment

    One year

  • Systolic blood pressure

    One year

  • Low-density lipoprotein cholesterol target attainment

    One year

  • Low-density lipoprotein cholesterol

    One year

  • Self-reported quality of life

    One year

  • +10 more secondary outcomes

Study Arms (3)

Usual care

NO INTERVENTION

Implementation of national guidelines on secondary prevention according to local plan and preferences

Audit and feedback

ACTIVE COMPARATOR

Audit and feedback on implementation of national guidelines on secondary prevention through the national quality registry SWEDEHEART

Other: Audit and feedback through a quality registry

Implementation support

ACTIVE COMPARATOR

Audit and feedback through the national quality registry SWEDEHEART and structured implementation support for implementation of national guidelines on secondary prevention

Other: Audit and feedback through a quality registryOther: Implementation support

Interventions

Centres answer CR process and structure variables through the SWEDEHEART registry every six months for three years. Feedback will be accessible online and through annual reports, enabling comparisons with own prior and other centres´ results.

Audit and feedbackImplementation support

On-site support to implement guidelines on secondary prevention applying practice facilitation - a multifaceted approach carried out by CR experts who enable personnel at intervention centres to address and overcome challenges in implementing guidelines.

Implementation support

Eligibility Criteria

Age18 Years - 79 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Centres report to the SWEDEHEART registry

You may not qualify if:

  • Unwillingness to participate in the study
  • Patient-level
  • Diagnosis of a type 1 MI registered in the SWEDEHEART registry
  • Age 18-79 years at discharge from hospital
  • Attended at least two follow-up visits at CR centres included in the study
  • None

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Skåne University Hospital

Malmo, 20502, Sweden

Location

Related Publications (1)

  • Michelsen HO, Lidin M, Back M, Duncan TS, Ekman B, Hagstrom E, Hagglund M, Lindahl B, Schlyter M, Leosdottir M. The effect of audit and feedback and implementation support on guideline adherence and patient outcomes in cardiac rehabilitation: a study protocol for an open-label cluster-randomized effectiveness-implementation hybrid trial. Implement Sci. 2024 May 24;19(1):35. doi: 10.1186/s13012-024-01366-8.

MeSH Terms

Conditions

Myocardial InfarctionRisk Reduction Behavior

Condition Hierarchy (Ancestors)

Myocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesInfarctionIschemiaPathologic ProcessesPathological Conditions, Signs and SymptomsNecrosisBehavior

Study Officials

  • Margret Leosdottir

    Skane University Hospital Malmö

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Model Details: Open-label Cluster-randomized Effectiveness-implementation Hybrid Trial
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Senior Cardiology Consultant, Associate Professor

Study Record Dates

First Submitted

March 23, 2023

First Posted

June 5, 2023

Study Start

October 1, 2023

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2030

Last Updated

November 29, 2024

Record last verified: 2024-11

Data Sharing

IPD Sharing
Will not share

The data to be used in this study is based on the SWEDEHEART registry. Access to data from the registry needs to be applied for and third-party data usage is not allowed, irrespective of whether the data contain potentially identifying or sensitive data or not. Instead, given ethical study approval from the Swedish Ethical Review Authority, access to SWEDEHEART data can be applied for from the Uppsala Clinical Research Center (UCR) in Sweden. Further information can be found on the UCR www.ucr.uu.se/en/ and Swedish Ethical Review Authority etikprovningsmyndigheten.se/ websites.

Locations